Carender Christopher N, Bollier Matthew J, Wolf Brian R, Duchman Kyle R, An Qiang, Westermann Robert W
University of Iowa Hospitals and Clinics, Department of Orthopedics and Rehabilitation, Iowa City, Iowa, USA.
Orthop J Sports Med. 2019 Jul 10;7(7):2325967119855001. doi: 10.1177/2325967119855001. eCollection 2019 Jul.
Use of the Patient-Reported Outcomes Measurement Information System (PROMIS) instrument has not yet been validated in patients undergoing operative treatment for patellofemoral malalignment and chondral disease.
To evaluate the PROMIS Physical Function Computer Adaptive Testing (PF CAT) instrument in a population of patients with patellofemoral malalignment and chondral disease relative to established patient-reported outcome (PRO) instruments.
Cohort study (diagnosis); Level of evidence, 2.
Eligible patients were prospectively enrolled at the time of indication for surgery and completed 5 PRO instruments preoperatively: 36-Item Short Form Health Survey (SF-36); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); Marx activity rating scale (Marx); EuroQol 5-dimension, 5-level instrument (EQ-5D-5L); and PROMIS PF CAT. Convergent and discriminant validity was assessed by measuring correlations between PROMIS PF CAT and other PRO instruments, including the Knee injury and Osteoarthritis Outcome Score (KOOS). Strength of correlation was measured by use of Spearman correlation coefficients.
In total, 37 patients (40 knees) were enrolled in the study. All knees underwent Fulkerson osteotomy and concomitant cartilage procedure (29 chondroplasty, 6 allograft, 5 microfracture). Mean patient age was 33.4 years, and 73% of knees were in female patients. Correlations () between PROMIS PF CAT and knee PRO instruments were as follows: SF-36 PF ( = 0.80; < .01); KOOS Pain ( = 0.74; < .01); KOOS Symptoms ( = 0.47; < .01); KOOS Quality of Life ( = 0.68; < .01); KOOS Sports and Recreation ( = 0.72; < .01); KOOS Activities of Daily Living (ADL) ( = 0.80; < .01); WOMAC Function ( = 0.80; < .01); WOMAC Pain ( = 0.72; < .01); WOMAC Stiffness ( = 0.38; = .02); Marx ( = 0.22; = .31); and EQ-5D-5L ( = 0.72; < .01). Neither floor nor ceiling effects were observed in PROMIS PF CAT or KOOS ADL. Mean (±SD) question burden with PROMIS PF CAT was 5.6 ± 0.6 questions.
In patients with patellofemoral malalignment and chondral disease, PROMIS PF CAT is an efficient and reliable PRO instrument to preoperatively assess patients across a spectrum of knee function without floor or ceiling effects.
患者报告结局测量信息系统（PROMIS）工具尚未在接受髌股关节对线不良和软骨疾病手术治疗的患者中得到验证。
在髌股关节对线不良和软骨疾病患者群体中，相对于既定的患者报告结局（PRO）工具，评估PROMIS身体功能计算机自适应测试（PF CAT）工具。
队列研究（诊断）；证据等级，2级。
符合条件的患者在手术指征确定时前瞻性入组，并在术前完成5种PRO工具的评估：36项简短健康调查问卷（SF - 36）；西安大略和麦克马斯特大学骨关节炎指数（WOMAC）；马克思活动评分量表（马克思）；欧洲五维度五水平量表（EQ - 5D - 5L）；以及PROMIS PF CAT。通过测量PROMIS PF CAT与其他PRO工具（包括膝关节损伤和骨关节炎结局评分（KOOS））之间的相关性来评估收敛效度和区分效度。相关性强度通过使用斯皮尔曼相关系数来衡量。
总共37例患者（40个膝关节）纳入研究。所有膝关节均接受了福克森截骨术及同期软骨手术（29例软骨成形术，6例同种异体移植，5例微骨折）。患者平均年龄为33.4岁，73%的膝关节为女性患者。PROMIS PF CAT与膝关节PRO工具之间的相关性（）如下：SF - 36身体功能（ = 0.80； <.01）；KOOS疼痛（ = 0.74； <.01）；KOOS症状（ = 0.47； <.0
